[Federal Register Volume 70, Number 102 (Friday, May 27, 2005)]
[Notices]
[Pages 30824-30825]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-10653]


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DEPARTMENT OF STATE

[Public Notice 5091]


30-Day Notice of Proposed Information Collection: Form DS-3057, 
Medical Clearance Update, OMB 1405-0131

ACTION: Notice of request for public comments.

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SUMMARY: The Department of State has submitted the following 
information collection request to the Office of Management and Budget 
(OMB) for approval in accordance with the Paperwork Reduction Act of 
1995.
    Title of Information Collection: Medical Clearance Update.
    OMB Control Number: 1405-0131.
    Type of Request: Extension of Currently Approved Collection.
    Originating Office: Office of Medical Services, M/MED/EX.
    Form Number: DS-3057.
    Respondents: Foreign Service Officers, Federal Government Employees 
and family members.
    Estimated Number of Respondents: 9,800.
    Estimated Number of Responses: 9,800.
    Average Hours Per Response: 30 minutes.
    Total Estimated Burden: 4,900.
    Frequency: On occasion.
    Obligation to Respond: Required to Obtain or Retain a Benefit.

DATES: Submit comments to the Office of Management and Budget (OMB) for 
up to 30 days from June 27, 2005.

ADDRESSES: Direct comments and questions to Katherine Astrich, the 
Department of State Desk Officer in the Office of Information and 
Regulatory Affairs at the Office of Management and Budget (OMB), who 
may be reached at 202-395-4718. You may submit comments by any of the 
following methods:
    E-mail: [email protected]. You must include the DS 
form number, information collection title, and OMB control number in 
the subject line of your message.
    Mail (paper, disk, or CD-ROM submissions): Office of Foreign 
Missions, U.S. Department of State, 2201 C Street, NW., Washington, DC 
20520.
    Fax: 202-395-6974.

FOR FURTHER INFORMATION CONTACT: Direct requests for additional 
information regarding the collection listed in this notice, including 
requests for copies of the proposed information collection and 
supporting documents, to Susan Willig, Department of State,

[[Page 30825]]

Office of Medical Services, SA-1 Room L101, 2401 E St., NW., 
Washington, DC 20052-0101, telephone 202-663-1754, or 
[email protected].

SUPPLEMENTARY INFORMATION: We are soliciting public comments to permit 
the Department to:
    Evaluate whether the proposed information collection is necessary 
for the proper performance of our functions.
    Evaluate the accuracy of our estimate of the burden of the proposed 
collection, including the validity of the methodology and assumptions 
used.
    Enhance the quality, utility, and clarity of the information to be 
collected.
    Minimize the reporting burden on those who are to respond, 
including the use of automated collection techniques or other forms of 
technology.
    Abstract of proposed collection: Form DS-3057 is designed to 
collect medical information for the Office of Medical Services to 
decide whether a federal employee and family members will have 
sufficient medical resources at a diplomatic mission abroad to maintain 
health and fitness.
    Methodology: The information collected will be collected through 
the use of an electronic forms engine or by hand written submission 
using a pre-printed form.

    Dated: April 28, 2005.
Maria C. Melchiorre,
Administrative Officer, Office of Medical Services, Department of 
State.
[FR Doc. 05-10653 Filed 5-26-05; 8:45 am]
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